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Respiratory medicine
Management of superior vena cava syndrome during lung transplantation for a patient with cystic fibrosis
  1. Binayak Upadhyay1,
  2. Michael I Anstead2,
  3. Suresh Keshavamurthy3 and
  4. John Gurley4
  1. 1Internal Medicine, Sinai Chicago, Chicago, Illinois, USA
  2. 2Adult and Pediatric Pulmonary, Critical Care and Sleep Medicine, University of Kentucky, Lexington, Kentucky, USA
  3. 3Cardiovascular & Thoracic Surgery, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
  4. 4Division of Cardiology, Department of Internal Medicine, University of Kentucky, Lexington, Kentucky, USA
  1. Correspondence to Dr Binayak Upadhyay; binayakupadhyay{at}gmail.com

Abstract

Central venous catheters including totally implantable venous access devices (TIVADs) have revolutionised the management of pulmonary infections and exacerbations in patients with cystic fibrosis (CF). While being better tolerated by the patient, these have allowed aggressive intravenous antibiotic therapies during recurrent hospitalisations. Given improvement in procedural strategies and operator experience, many patients with CF undergo lung transplants in the course of their disease nowadays. TIVADs can be associated with thrombosis leading to superior vena cava (SVC) obstruction and SVC syndrome which can pose a challenge, especially during the transplant surgery. We describe a case of successful management of SVC syndrome in a patient with CF undergoing a lung transplant, highlighting the strategies used to minimise risks associated with such a procedure.

  • Transplantation
  • Cystic fibrosis
  • Surgical diagnostic tests

https://doi.org/10.1136/bcr-2024-262156

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    Footnotes

    • X @skeshavamurthy3

    • Contributors All authors contributed equally to the article, and MIA is the guarantor. The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms and critical revision for important intellectual content: BU, SK, JG and MIA. The following authors gave final approval of the manuscript: BU, SK, JG and MIA.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.